Provider Demographics
NPI:1821326547
Name:GS REDDY INC
Entity Type:Organization
Organization Name:GS REDDY INC
Other - Org Name:CUMMING MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SURESH
Authorized Official - Middle Name:R
Authorized Official - Last Name:GUDUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACGS
Authorized Official - Phone:770-205-5720
Mailing Address - Street 1:416 PIRKLE FERRY RD
Mailing Address - Street 2:STE G100
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-9202
Mailing Address - Country:US
Mailing Address - Phone:770-205-5720
Mailing Address - Fax:770-205-5841
Practice Address - Street 1:416 PIRKLE FERRY RD
Practice Address - Street 2:STE G100
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-9202
Practice Address - Country:US
Practice Address - Phone:770-205-5720
Practice Address - Fax:770-205-5841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-19
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA042590207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty